REPORT TO THE BOARD OF DIRECTORS – November 2019

City

• On Wednesday, November 20, NYC Health + Hospitals Senior Vice President and Chief Information Officer Kevin Lynch testified at a City Council oversight hearing on electronic health records, convened by the Committee on Hospitals chaired by Council Member Carlina Rivera and the Committee on Technology chaired by Council Member Robert Holden. The purpose of the hearing was to allow NYC Health + Hospitals to update the Council on the implementation of our new electronic health records system and to highlight our successes and opportunities.
• On Thursday, November 21, Mayor de Blasio announced Outreach NYC – an integrated outreach effort to better serve homeless New Yorkers. NYC Health + Hospitals plays a key role in this work. Over the last 90 days, we have participated in both a review and a case conferencing process with various City partner agencies to identify where additional outreach is needed and have reviewed existing intensive treatment models. Through this process, we can identify current gaps that may lead our patients to move between our emergency rooms, shelters, and jails. This will remain a critical area of focus for our health system and our City partners.

State

• As news reports have indicated, the State is facing a potential significant Medicaid funding gap for SFY 20-21. We expect to know more details when State Department of Budget releases its mid-year update at the end of this month. We have already begun discussions with the State, which will continue as specifics of the situation emerge. We will keep the Board updated.
• On November 12, Dr. Wendy Wilcox represented NYC Health + Hospitals at a New York State Senate roundtable on maternal mortality. Dr. Wilcox joined state and city Department of Health representatives, as well as community-based organizations and other healthcare providers to discuss efforts to address maternal mortality in central Brooklyn.

Federal

• Congress is expected to again delay the pending Medicaid DSH cuts through a Continuing Resolution (CR) before midnight on November 21. The existing CR expires at that point, and negotiations continue this week. Conventional wisdom is that Congress will reach agreement for a short-term CR through December 20. Regardless of the timing, NYC Health + Hospitals will continue its advocacy for a long-term agreement on Medicaid DSH relief.

Earlier this week I was joined by the Mayor’s Office of Immigrant Affairs Commissioner Bitta Mostofi and our NYC Care leadership team to meet with representatives from our community based partner organizations who are helping to get to word out conducting culturally appropriate outreach to prospective NYC Care members in the Bronx. Our CBO partners – BronxWorks, Emerald Isle Immigration Center, Mekong NYC, Northwest Bronx Community and Clergy Coalition, and Sauti Yetu Center for African Women – have been instrumental in helping us enrolled more than 7,500 NYC Care members so far. Those who attended the meeting this week shared their experiences on the ground. They were particularly thankful for this program and reported that many of their clients had been offered an appointment with their new primary care doctor in two weeks or less. In fact, all new members have been offered an appointment in two weeks or less. They also underscored the importance of having outreach workers who are trusted in the community and language appropriate materials to help communicate our message. Thanks in great part of their help, we expect to meet our goal of 10,000 NYC Care members in the Bronx much sooner than the six month target timeline we had set for ourselves.

We are on track to launch NYC Care in Brooklyn and Staten Island early next year. We received strong proposals from CBOs in those boroughs in response to the RFP for outreach partners who can replicate the same great work our Bronx CBO partners have achieved. We look forward to announcing the new CBOs soon.

When I joined NYC Health + Hospitals as President, I knew I would want to get all my health care by our own great doctors and nurses and other health professionals and support staff. I have been very well cared for by a primary care doctor, a podiatrist and a physical therapist in our health system. However, I did not initially join our health insurance plan MetroPlus because my family was still in California, and, as with all local health plans, coverage out of the geographic service area is limited. Now that my husband and daughter have move to New York City (my son is still in Los Angeles finishing his last year of high school), I have taken advantage of this Open Enrollment period – which runs through November 29 — and switched to MetroPlus Gold – the best plan for NYC employees.I believe that health care dollars should all go to patients, and I am bothered with how private insurance companies have large administrative expenses and hurdles for getting care. In the case of for-profit plans, they are also earning money for Wall Street shareholders, instead of their beneficiaries.

While I am glad that we have choices among public and private plans, and among providers inside and outside our health system, I would recommend MetroPlus Gold to anyone who works for the City of New York. With all the talk about creating public insurance options, I am glad I already have one.

I signed on to a joint statement with NYC Mayor’s Office of Immigrant Affairs Commissioner Bitta Mostofi, DC37 Executive Director Henry Garrido, NYSNA President Judith Cutchin and Doctors Council President Dr. Frank Proscia to commend the court for halting the President’s Proclamation regarding visas for immigrants from going into effect this month. Denying visas to low-income immigrants, based on their ability to obtain health insurance upon arrival to the United States, flies in the face of the values of our city and our nation. Not only would the Proclamation have acted to separate families, it would have functioned as a wealth test to keep hundreds of thousands of immigrants from entering our country. The President’s mean-spirited and unworkable policy is part of a coordinated strategy to not only minimize immigration to the United States, but to confuse and intimidate immigrant families from accessing public programs and services for which they qualify under the law.

Our joint statement stressed that in New York City and at NYC Health + Hospitals, our doors are open to everyone. We won’t be swayed from our mission to deliver quality health care to all New Yorkers no matter their insurance status, their income, or where they come from. We urged Congress to continue to fight to protect immigrant families and to support an American healthcare system that makes quality health care accessible and affordable for all patients.

NYC Health + Hospitals marked the five year anniversary of the treatment and recovery of NYC’s only confirmed Ebola patient, Dr. Craig Spencer, and urged federal officials to continue funding for hospital preparedness around Ebola and other special pathogens. Dr. Spencer joined us at NYC Health + Hospitals/Bellevue to advocate for the continuation of the Hospital Preparedness Program Ebola funding that expires next year. Our health system receives $11.1M for health care and first responder training and regional coordination between public health, health care, EMS, and law enforcement to ensure our ability to respond quickly to an infectious disease emergency and keep patients and the public safe. The continuity of this funding is necessity if we are to be ready for the next deadly pathogen that comes through our doors.A highlight of this anniversary event included a thank you letter from Barack Obama addressed “to the folks at NYC Health + Hospitals” and said:

“As you well know, just five years ago, we were working hand-in-hand with our partners in West Africa to fight the deadliest Ebola outbreak the world had ever seen. Thousands of military members, civil responders and health care providers stepped up including, in a really crucial way, each of you. Thanks to your courage and expertise, your grit and your ingenuity, Dr. Craig Spencer, the first Ebola patient in New York, was cured. As you gather to celebrate this milestone and to reflect and to reenergize, please know you have my heartiest congratulations and enduring gratitude.”

The beautiful, bright colors of our health system’s Community Murals Project are officially on display. Last week, our Arts in Medicine program helped unveil the first three community murals, made possible through the Laurie M. Tisch Illumination Fund and the Mayor’s Fund to Advance New York City. NYC Health + Hospitals/McKinney in Brooklyn, NYC Health + Hospitals/Metropolitan in East Harlem and NYC Health + Hospitals/Carter in Harlem all held events to show off the artwork produced as collaborations between a renowned artist, patients, staff and community members. Each mural tells a story of the individuals and their diverse cultures represented by its community, as well as the history behind the NYC Health + Hospitals facility, such as the depiction of Dr. Susan McKinney and her legacy as a trailblazer.

The collaborative mural-making process has been a positive experience for our patients, residents, staff and community we serve. In the coming weeks, five additional murals will be unveiled at NYC Health + Hospitals Coney Island, North Central Bronx, Kings County, Queens and Bellevue.

For the second year in a row, NYC Health + Hospitals/Gouverneur received an overall 5 out of 5 rating in the U.S. News “Best Nursing Homes” list. The 295-bed skilled nursing facility ranked as “high performing” in both short-term rehabilitation and long-term care. U.S. News rated more than 15,000 nursing homes across the country to help consumers choose the most appropriate care for their loved ones. Less than 3,000 make the best nursing home list and even fewer receive a perfect score of 5 out of 5 for their quality of care, safety and caring staff. Just last month, NYC Health + Hospital/Gouverneur also made Newsweek best nursing home list, along with three other post-acute care facilities in our health system. This recognition is well deserved and I want to thank the team at Gouverneur for their tireless efforts to provide the kind of safe, quality and compassionate care we would want for any member of our own family.

NYC Health + Hospitals/Jacobi installed two new, state-of-the-art mammography imaging machines — the Hologic Affirm Prone 2D/3D stereotactic biopsy machine and the Hologic 2D/3D 3Dimensions Mammogram machine. These new machines visualize more tissue and pinpoint subtle lesions and faint calcifications that may not be visible with older technology. Greater precision not only allows for improved visibility of cancerous cells but also diminishes the number of patients recalled for screening mammograms due to “false positive” test results. As a result, the new equipment is expected to increase patient satisfaction, reduce wait times, and enhance patient experience. Special thanks to Councilmember Mark Gjonaj who contributed $400,000 and the Bronx Borough President Ruben Diaz Jr. who contributed $249,582 to help fund the new equipment.